The injection of nodules of Dupuytren's disease with triamcinolone acetonide

Ketchum, Lynn D.; Donahue, Terrence K.

doi:10.1053/jhsu.2000.18493

Cited by 145 publications

(108 citation statements)

References 8 publications

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“…Intralesional injection of a corticosteroid directly into palmar nodules can result in softening and reduction of pain. 45 This correlates with molecular studies which show that steroids can function as an antifibrotic agent, reducing cell proliferation, while inducing apoptosis or programmed cell death. 46,47 The potential side effects of steroid use are skin depigmentation and dermal atrophy from collagen degradation.…”

Section: Biologic Treatment Approachessupporting

confidence: 62%

Molecular mechanisms and treatment strategies for Dupuytren’s disease

O’Gorman¹,

Vi²,

Gan

2010

TCRM

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Dupuytren's disease (DD) is a common disease of the hand and is characterized by thickening of the palmar fascia and formation of tight collagenous disease cords. At present, the disease is incurable and the molecular pathophysiology of DD is unknown. Surgery remains the most commonly used treatment for DD, but this requires extensive postoperative therapy and is associated with high rates of recurrence. Over the past decades, more indepth exploration of the molecular basis of DD has raised the hopes of developing new treatment modalities. This paper reviews the clinical presentation and molecular pathophysiology of this disease, as well as current and emerging treatment. It also explores the implications of new findings in the laboratory for future treatment.

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Section: Biologic Treatment Approachessupporting

confidence: 62%

Molecular mechanisms and treatment strategies for Dupuytren’s disease

O’Gorman¹,

Vi²,

Gan

2010

TCRM

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“…Lack of understanding of the signaling pathways driving disease pathogenesis has meant that there is no specific therapeutic for treating early disease or for preventing recurrence following excision or division of the cord. The absence of valid targets has led to empirical treatment with modalities such as local steroid injection (16,17) or radiotherapy (26,27).…”

Section: Discussionmentioning

confidence: 99%

“…Histological studies have identified the presence of immune cells in Dupuytren's disease; in particular, the number of macrophages was shown to correlate with the quantity of myofibroblasts (15). Intralesional steroid injections led to temporary softening and flattening of Dupuytren's nodules (16) and reduced recurrence following percutaneous needle fasciotomy (17). It has been suggested that this therapeutic benefit of steroids in early Dupuytren's disease may be due to diminished leukocyte recruitment (18), as well as increased apoptosis of macrophages and fibroblasts, with reduced proliferation of the latter (19).…”

Section: Significancementioning

confidence: 99%

Unraveling the signaling pathways promoting fibrosis in Dupuytren's disease reveals TNF as a therapeutic target

Verjee

Verhoekx

Chan

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

118

130

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Significance Fibrosis, a hallmark of many clinical disorders, occurs because of uncontrolled myofibroblast activity. We studied Dupuytren's disease, a common hereditable fibrotic condition that causes the fingers to irreversibly curl toward the palm. We found that freshly isolated tissue from Dupuytren's patients contained macrophages and released proinflammatory protein mediators (cytokines). Of the cytokines, only TNF selectively converted normal fibroblasts from the palm of patients with Dupuytren's disease into myofibroblasts via activation of the Wnt signaling pathway. Conversely, blockade of TNF resulted in reversal of the myofibroblast phenotype. Therefore, TNF inhibition may prevent progression or recurrence of Dupuytren's disease.

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“…In one study an average of 3.2 local injections of glucocorticoids lead to a significant disease regression [13] but also to severe complications like atrophy at the injection site or rupture of the flexor tendon and have no long-term impact on disease progression. Without any therapy, progression is observed in about 50% of patients after a follow-up of 6 years [19].…”

Section: Introductionmentioning

confidence: 99%